Building a national hernia registry in South Africa: initial ventral hernia repair results from a diverse healthcare sector

Gouws, J. F.; Nel, D; Bougard, Heather; Sofianos, C; Reimers, González; Rayamajhi, Shreya; Fölscher, D. J.; Beer, Raphael; Rademan, R. J.; Donkin, I. E.; Swart, N.; Taran, O. S.; Campbell, N. C.; Kloppers, Christo

doi:10.1007/s10029-020-02306-3

Cited by 5 publications

(6 citation statements)

References 17 publications

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“…The proportion of patients that had strangulation in total was 40.3%. These results are comparable to a study done by Gouws et al (13) in South Africa about hernia repair, which observed that 37.5% of the patients operated on as emergency cases had a strangulated hernia. Another study from Saudi Arabia done by Altaf & Algethmi (14) about the risk of bowel resection in emergency hernia reported that the proportion of strangulation was 36.1%, while obstruction and irreducible hernia were 37% and 19.3% respectively.…”

Section: Discussionsupporting

confidence: 89%

“…This was an elderly patient who presented with strangulated femoral hernia, resection and end to end anastomosis was done, but later she developed anastomotic leak and intra-abdominal sepsis. Contrary to our study, a retrospective review of patients that had emergency hernia surgery in South Africa noted that 5.2% of the patients died following surgery (13). When Gouws et al (13) reviewed the hernia registry of South Africa, they observed that all the mortalities that were seen in hernia patients occurred among patients that had an emergency hernia surgery, with 5.7% of the patients that had emergency surgeries reported to have died.…”

Section: Discussioncontrasting

confidence: 86%

“…Contrary to our study, a retrospective review of patients that had emergency hernia surgery in South Africa noted that 5.2% of the patients died following surgery (13). When Gouws et al (13) reviewed the hernia registry of South Africa, they observed that all the mortalities that were seen in hernia patients occurred among patients that had an emergency hernia surgery, with 5.7% of the patients that had emergency surgeries reported to have died. The mortalities in both studies were much higher than our study possibly because these studies included all types of emergency abdominal hernia, and had a longer follow-up duration.…”

Section: Discussioncontrasting

confidence: 86%

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Predictors of early adverse postoperative outcomes following emergency groin hernia surgery: a prospective multicenter cohort

Ismail,

Abra,

Muhumuza

et al. 2023

Preprint

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Introduction: Groin hernias accounts for 70% of all abdominal hernias and up to 40% of the groin hernia operations are done as emergencies. The percentage of groin hernias operated as emergencies is even higher in low and middle-income countries like Uganda. Emergency hernia surgeries have been associated with a higher risk of adverse outcomes. This study was aimed at determining the predictors of early adverse postoperative outcomes following emergency groin hernia surgery in a low resource setting. Methods: This was a prospective multicenter cohort conducted in the surgical departments of Hoima Regional Referral Hospital (HRRH) and Jinja Regional Referral Hospital (JRRH). All patients who presented with emergency groin hernias during the study period were enrolled. Follow up was done up to discharge. Binary logistic regression in SPSS version 26 was done to determine the predictors. Results: During the study period, 67 patients were enrolled majority of whom were males 56 (83.6%) aged above 45 years 28 (41.8%). Irreducible and obstructed hernias accounted for 20(29.9%) each. Strangulated hernia being the commonest with 27(40.3%) patients, of which 9 were found to have both obstruction and strangulation. Twenty (29.9%) of the participants had complications. The mean length of hospital stay was 5.97 (SD=3.289) days. One (1.5%) patient died. Undergoing gut resection predicted occurrence of early adverse outcomes (AOR=10.250, CI=2.970-35.372, P<0.001). Conclusion More attention is still needed to reduce the rate of adverse outcomes following emergency hernia surgery with a lot of focus on surgical site infection and patients undergoing gut resection.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 86%

Section: Discussioncontrasting

confidence: 86%

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Predictors of early adverse postoperative outcomes following emergency groin hernia surgery: a prospective multicenter cohort

Ismail,

Abra,

Muhumuza

et al. 2023

Preprint

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“…Follow-up was notably better in the private sector (42%) than in the public sector (14%). 10 To gain long term benefit from this registry, better follow-up data capture will be required. The methodology could be criticised as an arbitrary cut-off for compliance was set and the six guidelines selected might not be representative of actual compliance to the HIG(SA) guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…4,9 Following these guidelines, the HIG(SA) launched a South African national hernia registry in February of 2019. Review of the ventral hernia aspect of this registry revealed the participation of 43 surgeons, 29 (67%) of whom were from the public sector, while 14 (33%) were practising in a private capacity. 10 This study evaluates the initial results of the HIG(SA) registry. We aim to provide a snapshot of the current practice in ventral hernia repair in SA by assessing compliance of both the public and private healthcare sectors to six selected HIG(SA) ventral hernia guideline recommendations.…”

Section: Introductionmentioning

confidence: 99%

Compliance to the South African ventral hernia guidelines: inaugural results from the HIG(SA) registry

et al. 2021

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BACKGROUND: The Hernia Interest Group (HIG) of South Africa (SA), following the publication of their inguinal and ventral hernia guidelines (in 2015 and 2016 respectively), developed a hernia registry, the HIG(SA) hernia registry METHODS: A retrospective analysis of the prospectively maintained HIG(SA) hernia registry from 1 February 2019 to 29 February 2020. Compliance to six recommendations made in the HIG(SA) ventral hernia guidelines were assessed in both the public and private healthcare systems RESULTS: Three hundred and fifty-three ventral hernia repair cases were included in the study. Fifty-four per cent were private and 46% were public sector cases. Laparoscopic repair for patients with a BMI > 35 kg/m2 occurred in 38% of eligible cases and a minimum 5 cm of mesh overlap was achieved in 50% of cases. Overall, 80% of elective cases occurred in non-smokers; 97% of the intraperitoneal on-lay mesh (IPOM) repairs used composite mesh; 96% of ventral hernias with defects of larger than 2 cm and 95% of incisional hernias were repaired with mesh. Non-smokers undergoing repair numbered 72% in public and 85% in private practice, p = 0.01 CONCLUSION: Ventral hernia repair practices in SA facilities overall had good compliance to four out of the six HIG(SA) ventral hernia guidelines highlighted for the purposes of this study. The two guidelines that had poor compliance overall were 'laparoscopic repair for patients with a BMI of > 35 kg/m2' and 'ensuring a mesh overlap of 5 cm'. The public sector had higher rates of current smokers undergoing elective ventral hernia repair Keywords: registry, low-middle income countries, ventral hernia, hernia guidelines

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Adult groin hernia surgery in sub-Saharan Africa: a 20-year systematic review and meta-analysis

Ndong

Tendeng

Diallo

et al. 2022

Hernia

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Building a national hernia registry in South Africa: initial ventral hernia repair results from a diverse healthcare sector

Cited by 5 publications

References 17 publications

Predictors of early adverse postoperative outcomes following emergency groin hernia surgery: a prospective multicenter cohort

Predictors of early adverse postoperative outcomes following emergency groin hernia surgery: a prospective multicenter cohort

Compliance to the South African ventral hernia guidelines: inaugural results from the HIG(SA) registry

Adult groin hernia surgery in sub-Saharan Africa: a 20-year systematic review and meta-analysis

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